Wrangling With Reduction

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“Are you Catholic or Mormon?” As the oldest of six kids growing up in Southern California, I was used to comments from strangers about the unusually large size of our family. When my husband and I started trying for kids at the respective ages of 38 and 35, the odds seemed slim that we’d have our own abundant offspring to be ogled at. Well, three years and five healthy kids later, we can honestly say we never saw this situation coming. But our journey to becoming a large family has not come without some major hand wringing and difficult decision-making.

We have one singleton daughter conceived by IVF and infant quadruplets conceived with the aid of reproductive medication. When my husband, Charlie, and I found out we were expecting quadruplets, you can imagine our surprise. I had hoped for twins, was fearful about triplets, but never in a million years imagined carrying four babies.

But there was no real time to let the shock set in, as our physicians immediately started asking us about whether or not we would “selectively reduce”. All obstetricians want the healthiest outcome for mom and baby (…or babies), and the fewer babies you carry, the lower risk your pregnancy is. I was surprised to learn from a number of OBs that with quadruplets, the general recommendation is to selectively reduce down to two babies. A twin pregnancy is still high risk, but nothing in the realm of triplet or higher pregnancies. We were assured that a simple, painless procedure would eliminate two of the potential children we had hoped and prayed so hard to bring into the world.

In researching this selective reduction situation, Charlie and I kept hearing over and over that there is a 50 percent chance of severe handicap in quadruplets. The severe handicap risk is due almost entirely to the effects of premature labor. The average length of gestation in a quadruplet pregnancy is 28 weeks, which is basically three months shy of a full term pregnancy. And the fewer babies I could carry, ideally the longer I could stay pregnant. But at what cost?

Charlie and I had some of the hardest conversations of our life trying to wrangle with this idea of selective reduction. Fifty percent chance of severe handicap? I teach college kids, 50 percent is an F. Would it really be fair to try to bring four kids into the world knowing there’s a pretty good shot at least half of them will suffer? But on the other hand, there’s a 50 percent chance that they won’t. And what sort of amazing human beings are we foregoing if we make the wrong decision? How would life with disabled children affect our healthy older daughter, our marriage, and our finances?

For a week, we went back and forth between the ideas of twins versus quadruplets. Charlie and I are both practicing Catholics and we were forced to examine our faith and how we would cope with the outcome of either decision. Although we knew we dramatically increased the risk of a dangerous high-order multiples pregnancy when we made the decision to pursue fertility treatment, at the end of the day, we just did not feel it was our right to arbitrarily remove the life that science and God had joined hands in giving to us.

Eventually, against the recommendations of every specialist we had met with, Charlie and I decided against selective reduction. We pressed forward with the pregnancy and mentally prepared ourselves for life with four potentially severely handicapped children.

As 20 weeks of pregnancy stretched into 24, 28 and then 30, I started to accept that we might actually become quadruplet parents, and maybe this situation was not going to be so terrible. Our doctors discussed delivering no later than 34 weeks, although in the back of my head I never really believed we would make it that far. But low and behold, 34 weeks came and four beautiful babies were delivered by scheduled C-section, with over 30 attendants and specialists in the room for the delivery.

Charlie and I opted not to find out the genders ahead of time and we were overjoyed when our three boys and one girl quadruplets - Charlie, Claire, Henry and Dillon - all entered the world within one minute of each other and each weighing between 3 ½ and 4 pounds. They spent one month in the neonatal intensive care unit (NICU) but had no major health issues, just requiring a few weeks’ time to learn to breathe, coordinate eating and grow.

Charlie, Claire, Henry and Dillon are now nine months old and are tracking well for their adjusted ages. There is no doubt that along with their big sister Molly, these kids are the center of our universe. And there is not a day that goes by where we don’t reflect on how glad we are we decided to ignore the initial advice to reduce.

Of course we are perfectly aware that the situation could have gone the other way and we have no reasonable explanation as to why we are so lucky. Understandably, many infertility stories do not end nearly as well…and perhaps another family would not have been so accepting of a similar quadruplet situation or considered it the blessing that we now do.

Our hope is that other families considering reduction will know there certainly is a happier side to the picture many pro-reduction OB specialists present. They claim to have evidence to back up their recommendations, but the sample size for triplet, quadruplet and higher order multiple births is so small compared to twins and singletons it is statistically insignificant. There are situations where sentiment can sometimes outweigh statistics and we feel so fortunate that we made the decision not to reduce.

Our fertility office staff members all wear the same shirts every Friday. The shirt features a bunch of babies bouncing off of curly-cue lines with the caption, “The path to parenthood is rarely straight.” Despite the roundabout way that we got here, we cannot imagine life without any of our babies. And we are proud to say that we have even gotten to the point where we welcome the weird comments and questions from perfect stranger bystanders. Now, to the “Are you Catholic or Mormon?” question, we just answer…, “We’re crazy!”